Gita D Mishra1, Hsin-Fang Chung2, Antonio Cano3, Peter Chedraui4, Dimitrios G Goulis5, Patrice Lopes6, Alfred Mueck7, Margaret Rees8, Levent M Senturk9, Tommaso Simoncini10, John C Stevenson11, Petra Stute12, Pauliina Tuomikoski13, Irene Lambrinoudaki14. 1. School of Public Health, Faculty of Medicine, University of Queensland, Brisbane 4006, Australia. Electronic address: g.mishra@sph.uq.edu.au. 2. School of Public Health, Faculty of Medicine, University of Queensland, Brisbane 4006, Australia. 3. Department of Pediatrics, Obstetrics and Gynecology, University of Valencia and INCLIVA, Valencia, Spain. 4. Instituto de Investigación e Innovación en Salud Integral (ISAIN), Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador. 5. Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece. 6. Nantes, France Polyclinique de l'Atlantique Saint Herblain, F 44819 St Herblain, France; Université de Nantes F 44093 Nantes Cedex, France. 7. University Women's Hospital of Tuebingen, Calwer Street 7, 72076 Tuebingen, Germany. 8. Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK. 9. Istanbul University Cerrahpasa School of Medicine. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, IVF Unit, Istanbul, Turkey. 10. Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy. 11. National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, London SW3 6NP, UK. 12. Department of Obstetrics and Gynecology, University Women's Hospital, Bern, Switzerland. 13. Helsinki University and Helsinki University Hospital, Eira Hospital, Helsinki, Finland. 14. Second Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Greece.
Abstract
INTRODUCTION: While the associations of genetic, reproductive and environmental factors with the timing of natural menopause have been extensively investigated, few epidemiological studies have specifically examined their association with premature (<40 years) or early natural menopause (40-45 years). AIM: The aim of this position statement is to provide evidence on the predictors of premature and early natural menopause, as well as recommendations for the management of premature and early menopause and future research. MATERIALS AND METHODS: Literature review and consensus of expert opinion. RESULTS AND CONCLUSIONS: Strong genetic predictors of premature and early menopause include a family history of premature or early menopause, being a child of a multiple pregnancy and some specific genetic variants. Women with early menarche and nulliparity or low parity are also at a higher risk of experiencing premature or early menopause. Cigarette smoking (with a strong dose-response effect) and being underweight have been consistently associated with premature and early menopause. Current guidelines for the management of premature and early menopause mainly focus on early initiation of hormone therapy (HT) and continued treatment until the woman reaches the average age at menopause (50-52 years). We suggest that clinicians and health professionals consider the age at menopause of the relevant region or ethnic group as part of the assessment for the timing of HT cessation. In addition, there should be early monitoring of women with a family history of early menopause, who are a child of a multiple pregnancy, or who have had early menarche (especially those who have had no children). As part of preventive health strategies, women should be encouraged to quit smoking (preferably before the age of 30 years) and maintain optimal weight in order to reduce their risk of premature or early menopause.
INTRODUCTION: While the associations of genetic, reproductive and environmental factors with the timing of natural menopause have been extensively investigated, few epidemiological studies have specifically examined their association with premature (<40 years) or early natural menopause (40-45 years). AIM: The aim of this position statement is to provide evidence on the predictors of premature and early natural menopause, as well as recommendations for the management of premature and early menopause and future research. MATERIALS AND METHODS: Literature review and consensus of expert opinion. RESULTS AND CONCLUSIONS: Strong genetic predictors of premature and early menopause include a family history of premature or early menopause, being a child of a multiple pregnancy and some specific genetic variants. Women with early menarche and nulliparity or low parity are also at a higher risk of experiencing premature or early menopause. Cigarette smoking (with a strong dose-response effect) and being underweight have been consistently associated with premature and early menopause. Current guidelines for the management of premature and early menopause mainly focus on early initiation of hormone therapy (HT) and continued treatment until the woman reaches the average age at menopause (50-52 years). We suggest that clinicians and health professionals consider the age at menopause of the relevant region or ethnic group as part of the assessment for the timing of HT cessation. In addition, there should be early monitoring of women with a family history of early menopause, who are a child of a multiple pregnancy, or who have had early menarche (especially those who have had no children). As part of preventive health strategies, women should be encouraged to quit smoking (preferably before the age of 30 years) and maintain optimal weight in order to reduce their risk of premature or early menopause.
Authors: Christine R Langton; Brian W Whitcomb; Alexandra C Purdue-Smithe; Lynnette L Sievert; Susan E Hankinson; JoAnn E Manson; Bernard A Rosner; Elizabeth R Bertone-Johnson Journal: Am J Epidemiol Date: 2022-03-24 Impact factor: 5.363
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Authors: Elizabeth R H Rizza; John J DiGiovanna; Sikandar G Khan; Deborah Tamura; Jack D Jeskey; Kenneth H Kraemer Journal: J Invest Dermatol Date: 2021-01-09 Impact factor: 8.551